Solomon A, Pires R T, Tseng S C
Ocular Surface and Tear Center, Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL 33136, USA.
Ophthalmology. 2001 Mar;108(3):449-60. doi: 10.1016/s0161-6420(00)00567-4.
To evaluate the postoperative outcome and the recurrence rate after extensive removal of primary and recurrent pterygia combined with amniotic membrane transplantation.
A noncomparative interventional case series.
Fifty-four eyes in 54 subjects with either primary (n = 33) or recurrent (n = 21) pterygia operated on by one surgeon (SCGT).
All subjects were operated on for pterygia with an extensive excision of the lesion followed by amniotic membrane transplantation and intraoperative injection of a depot corticosteroid.
Cumulative rates of conjunctival (grade 3) and corneal (grade 4) recurrence and incidence of complications.
The mean follow-up was 12.8 +/- 4.3 months for primary and 14.3 +/- 4.9 months for recurrent pterygia. The true recurrence rate (grade 4) was 3.0%, 9.5%, and 5.6% for primary, recurrent, and all pterygia, respectively. The cumulative proportion of recurrence-free eyes at 12 months was 0.90 +/- 0.06 for primary and 0.69 +/- 0.11 for recurrent pterygia (P = 0.047, log-rank test). Removal of the semilunar fold was associated with longer survival times (P = 0.063) and decreased failure rate (P = 0.046). A similar success rate was achieved in double-head pterygia (1 recurrence in 11 eyes).
Amniotic membrane transplantation is an effective and safe procedure for pterygium surgery, with a relatively low recurrence rate for both primary and recurrent pterygia. It can be a useful alternative to conjunctival autograft when a large conjunctival defect has to be covered, such as in primary double-head pterygia and in large recurrent pterygia.
评估原发性和复发性翼状胬肉广泛切除联合羊膜移植术后的疗效及复发率。
非对照性干预病例系列。
54例患者的54只眼，其中原发性翼状胬肉33例，复发性翼状胬肉21例，均由同一位外科医生（SCGT）进行手术。
所有患者均接受翼状胬肉切除术，广泛切除病变组织，随后进行羊膜移植，并在术中注射长效糖皮质激素。
结膜（3级）和角膜（4级）复发的累积发生率及并发症发生率。
原发性翼状胬肉的平均随访时间为12.8±4.3个月，复发性翼状胬肉为14.3±4.9个月。原发性、复发性和所有翼状胬肉的真正复发率（4级）分别为3.0%、9.5%和5.6%。原发性翼状胬肉在12个月时无复发眼的累积比例为0.90±0.06，复发性翼状胬肉为0.69±0.11（P = 0.047，对数秩检验）。切除半月皱襞与更长的生存时间相关（P = 0.063），失败率降低（P = 0.046）。双头翼状胬肉的成功率相似（11眼中1例复发）。
羊膜移植是一种有效且安全的翼状胬肉手术方法，原发性和复发性翼状胬肉的复发率相对较低。当需要覆盖较大的结膜缺损时，如原发性双头翼状胬肉和大型复发性翼状胬肉，它可以作为结膜自体移植的有用替代方法。
